Asmaou Bouba Dalil, Gomes Souza Lucas, Dofara Suélène Georgina, Guay-Bélanger Sabrina, Gadio Souleymane, Mochcovitch Diogo, Paquette Jean-Sébastien, Izumi Shigeko Seiko, Archambault Patrick, Totten Annette M, Rivest Louis-Paul, Légaré France
Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada.
VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada.
J CME. 2024 Nov 3;13(1):2420475. doi: 10.1080/28338073.2024.2420475. eCollection 2024.
We aimed to measure the sustainability of health professionals' intention to have serious illness conversations with patients using the Serious Illness Conversation Guide (SICG) after individual-focused training versus team-based training. In a cluster randomised trial, we trained healthcare professionals in 40 primary care clinics and measured their intention to hold serious illness conversations immediately (T1), after 1 year (T2) and after 2 years (T3). Primary care clinics ( = 40) were randomly assigned to individual-focused training (comparator) or team-based training (intervention). Average age of the 373 participants was 35-44 years, 79% were women. On a scale of 1 to 7, at T1, the mean intention was 5.33 (SD 0.20) in the individual-focused group and 5.36 (SD 0.18) in the team-based group; at T2, these scores were 4.94 (SD 0.23) and 4.87 (SD 0.21) and at T3, 5.14 (SD 0.24) and 4.59 (SD 0.21), respectively. At T3, the difference in mean intention between study groups had a significant p-value of 0.01. Intention to have serious illness conversations was lower at T2 and T3 after team-based training than after individual-focused training, with a significant difference at 2 years in favour of individual-focused training. Health professionals reported not enough time during consultations for serious illness conversations as a major barrier.
ClinicalTrials.gov (ID NCT03577002) for the parent clinical trial.
我们旨在衡量在针对个人的培训与基于团队的培训之后，使用《重病谈话指南》（SICG）的医疗保健专业人员与患者进行重病谈话意愿的可持续性。在一项整群随机试验中，我们对40家初级保健诊所的医疗保健专业人员进行了培训，并在即刻（T1）、1年后（T2）和2年后（T3）测量了他们进行重病谈话的意愿。40家初级保健诊所被随机分配到针对个人的培训（对照）或基于团队的培训（干预）。373名参与者的平均年龄为35 - 44岁，79%为女性。在1至7的量表上，T1时，针对个人的培训组平均意愿为5.33（标准差0.20），基于团队的培训组为5.36（标准差0.18）；T2时，这些分数分别为4.94（标准差0.23）和4.87（标准差0.21），T3时分别为5.14（标准差0.24）和4.59（标准差0.21）。在T3时，研究组之间平均意愿的差异具有显著的p值0.01。与针对个人的培训相比，基于团队的培训后T2和T3时进行重病谈话的意愿较低，在2年时差异显著，有利于针对个人的培训。医疗保健专业人员报告称，咨询期间没有足够时间进行重病谈话是一个主要障碍。
母临床试验的ClinicalTrials.gov（ID NCT03577002）。
